Antiseptic Liquid
NDC Package 79903-151-75

View Billable Units, 11-Digit Conversion Format, and RxNorm mappings
Table of Contents
    1. Package Information
    2. Other Packages
    3. Frequently Asked Questions

Package Information

Antiseptic (eucalyptol, menthol, methyl salicylate, thymol) liquids is adults and children 12 years of age and older: vigorously swish 20 milliliters of rinse between your teeth twice a day for 30 seconds and then spit out. This formulation utilizes a liquid delivery system. Marketed by Walmart Inc. (see Also Equate), this product is identified by NDC 79903-151 and is authorized under FDA application M022.

Identification & Billing

NDC Package Code
79903-151-75
Package Description
1.5 mL in 1 BOTTLE, PLASTIC
Product Code
79903-151
11-Digit Billing Format
79903015175
RxNorm Crosswalk
  • RxCUI: 1043619 - eucalyptol 0.092 % / menthol 0.042 % / methyl salicylate 0.06 % / thymol 0.064 % Mouthwash
  • RxCUI: 1043619 - eucalyptol 0.92 MG/ML / menthol 0.42 MG/ML / methyl salicylate 0.6 MG/ML / thymol 0.64 MG/ML Mouthwash

Clinical Specifications

Proprietary Name
Antiseptic
Non-Proprietary Name
Eucalyptol, Menthol, Methyl Salicylate, Thymol
Substance Name
Eucalyptol; Menthol; Methyl Salicylate; Thymol
Dosage Form
Liquid - A dosage form consisting of a pure chemical in its liquid1 state. This dosage form term should not be applied to solutions.
Administration Route
Oral - Administration to or by way of the mouth.
Active Ingredient(s)
Usage Information
Adults and children 12 years of age and older: vigorously swish 20 milliliters of rinse between your teeth twice a day for 30 seconds and then spit out. Do not swallow the rinse.children 6 years to under 12 years of age: supervise usechildren under 6 years of age: do not use

Regulatory & Marketing

Labeler Name
Walmart Inc. (see Also Equate)
Product Type
Human Otc Drug
FDA Application #
M022
Marketing Category
OTC MONOGRAPH DRUG -
Start Marketing Date
12-30-2022
Listing Expiration
12-31-2026
Exclude Flag
N
Sample Package
No

Hierarchy Structure

Code Lineage

The NDC Directory contains ONLY information on final marketed drugs submitted to FDA electronically by labelers. A labeler might be a manufacturer, re-packager or re-labeler. The product information included in the NDC directory does not indicate that FDA has verified the information provided by the product labeler. Assigned NDC numbers are not in any way an indication of FDA approval of the product.

* Please review the full disclaimer at the bottom of this page.

Other Available Packages

The following commercial packages are registered under the same Product NDC (79903-151). Click a package code to view its specific billing and regulatory data.

79903-151-50
500 mL in 1 BOTTLE, PLASTIC
79903-151-99
2 BOTTLE, PLASTIC in 1 PACKAGE / 1.5 mL in 1 BOTTLE, PLASTIC

* Please review the full disclaimer at the bottom of this page.

Frequently Asked Questions

What is the distribution configuration for this product package?

The code 79903-151-75 identifies a specific commercial package of 1.5 ml in 1 bottle, plastic of Antiseptic, a human over the counter drug labeled by Walmart Inc. (see Also Equate). This liquid is formulated for oral use and contains eucalyptol; menthol; methyl salicylate; thymol as the active substance.

Is this product currently listed with the FDA?

Yes, this product is active and verified within the NDC Directory. It was introduced to the market by Walmart Inc. (see Also Equate) on December 30, 2022. The current certification is valid through December 31, 2026.

How is this Walmart Inc. (see Also Equate) product billed for insurance claims?

For medical billing and reimbursement, this package follows the 11-digit CMS format: 79903015175. The table below illustrates the segment conversion from the 10-digit labeler code to the 11-digit provider format.

11-Digit Code Conversion

Billing payers usually require a 5-4-2 segment configuration. Below is the conversion from the 10-digit package format to the 11-digit billing format:

10-Digit Format (5-3-2)
79903-151-75
11-Digit CMS (5-4-2)
79903-0151-75

Note: The zero is added to the Product segment to maintain the 5-4-2 structure.